Work Culture

Definition/Introduction

Work culture is an organizational management concept which deals with the attitudes, beliefs, and perceptions of employees relative to the principles and practices adhered to by the institution. In the healthcare setting, work culture determines how medical, nursing, ancillary staff and other professionals actually work together in the pursuit of achieving organizational goals -- whether they work in clinics, hospitals, health centers, and other health institutions.

Major components of the work culture as it applies in healthcare practice include the statement of its mission and vision, institutional policies, work procedures, and organizational rules. Additionally, the current state of organizational development is an essential element for every healthcare setting as it determines the maturity of the organization which could directly influence the work culture as a whole. Considering these essential elements, every member of the organization, both from healthcare managers and staff, expects that a strong work culture must exist to maximize potentials in serving patients. Positive work culture is geared towards progressive improvement for the individual staff and the organization while a negative work culture fosters disintegration, loss of cooperation and collaboration among staff. Thus, this will result in regressing organizational value and overall performance. With this, it is crucial that work culture is assessed and improved in every health organization as it will significantly impact healthcare staff, leaders and managers, the organization itself and more importantly patient outcomes in terms of health.

Issues of Concern

The following factors have been described to be associated work culture of specific health care organization, dichotomized into positive and negative work cultures. Positive work cultures must be continually enhanced while learnings from negative work cultures must be sought and applied so as not to cause any further problems in the future.[1]

Positive Work Culture

To create a work culture that will bring about a significant positive change in an organization, good leadership behavior is essential in maintaining the relationship of the team. Leaders who can scan the situation and the needs of the individual staff is a necessary skill to identify and bridge possible gaps in work implementation. Aligning the members to the direction of the organization sets the tone of the work for every member. When each staff at every level of the organization becomes fully aware of the situation, it will then become more natural for the leaders to mobilize the whole team and to delegate appropriate tasks in carrying out individual functions. Lastly, a leader who can inspire his colleagues in the organization will develop a positive work culture for all. Emphasis on these essential roles must be well taught to healthcare managers since every organization or team is unique on its own. When members of the organization have established a harmonious relationship with its leaders and vice versa, performance and satisfaction at work will be enhanced.[2][3]

Aside from leadership abilities, management skills require emphasis for all persons who are tasked to manage a unit, a section, a department or the administrative body of any healthcare organization. Managers must be well skilled in developing plans for the organization, organizing staff and attending to their needs at work. They should be able to have control of the organization especially to the implementation of the organization's mandate as a whole. Furthermore, managers who always monitor the progress of work implementation, and those who evaluate the organizational impact of its work on patients, do always have a more accurate view of the status of any healthcare institution. Managers and leaders can be two different things, but real leaders who strongly influence positive work culture always demonstrate both sets of skills. No employee could ever be more motivated and empowered to do the work when there are elements of trust and supportive supervision of one's performance and welfare at work.[4]

Another critical aspect that mediates the positive culture at work is the value of teamwork. Teamwork is the union of individual members to achieve a specific goal. Every healthcare organization, just like in other business entities, usually conduct activities that will enhance teamwork in the organization. Regularly, team building activities can help with the primary goal of uniting the members and not for rest and recreation. Healthcare managers should be able to come up with strategies that will engage the participation of all members that would soon break barriers to a good relationship at work.[5][6] When improving on teamwork, there are two central relationships involved: one between individual members; and one between managers and staff. Additionally, teamwork in healthcare settings should not include only healthcare professionals but also all other staff (ancillary services, administrative services, and the like) that are part of the organization. Successful teams sustain a positive work culture.[7][8]

Negative Work Culture

Excessive and prolonged stress among healthcare staff leads to burnout.[9] Hospitals, medical centers, and other health institutions are known to be demanding in terms of work. Work shifts among staff are in place, however, cannot still cope up with the demands required by each unit or department especially in government healthcare institutions and large healthcare private institutions as well. When these burnouts continue to inflict our healthcare teams who provide direct patient care and services, it will later impact negatively on the quality of care that they provide. Individual patients themselves can feel these changes. Recommendations may include the formulation of strategies that will determine the source of the stress and to apply interventions that will aid in minimizing if not eliminating stress and burnout at healthcare settings.

Another aspect related to the negative culture at work is absenteeism.[10] Due to the accumulation of stress at work, healthcare staff tends to lose satisfaction in performing their tasks and would eventually result in absence from work, which reduces productivity for the organization and would limit the quality of services that they provide. Aside from the demands from work, the staff sees going to work as a burden when they feel dissatisfied with leadership, experience blame, confusion, and discrimination, as well as incivility among colleagues.[11]

As both leaders and managers of a healthcare organization, it is imperative that these concerns receive proper attention other than just focusing on how to increase work output and profit. Leadership must remember that all healthcare staff, encompassing administrators, doctors, nurses, laboratory staff, pharmacists, technicians, hospital engineers, clerks, and housekeeping service personnel and other parts of the workforce are the essential resource of the healthcare system. Applying strategies that will work out a solution to sustain and continuously improve the positive work culture should always be a priority.

Clinical Significance

Work culture whether positive or negative significantly impacts the quality of care and delivery of health services to patients.[12] Positive work culture will always support the healthcare professional-patient relationship. It will build patient trust and gain confidence among staff who provide patient care. It will allow them to feel that other than the goal of working to cure their diseases, they receive care. When patients see doctors and nurses who are satisfied in doing their work and providing services, it enables them to follow instructions given to them (e.g., compliance with medications). When they feel teamwork is active among staff and stable leadership exists from their managers, these patients may be more than willing to allow themselves to seek medical advice and treatment.